S/o What the f do you all want from doctors?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Currently primary care doctors make 250-300 k and no one wants to do it. They try to get doctors to work out in rural areas for 600k and no one wants it. If anyone would be dumb enough to become a surgeon with 300k student loans and the hell they go through, I wouldn’t want them as my surgeon. This is America- most smart ppl want to make good money.

$300k is good money. And the issue isn't that people don't want to be PCPs- it's that specialists make so much more money.

Basically, PCPs, in some cases, are slightly underpaid, while some specialists are grossly overpaid. So people are attracted to the grossly overpaid positions if they can get into them.

Just hop on over to the college forum. The absolute only thing that counts as success over there, other than getting into an Ivy, is landing an extremely high paying job.

[Anonymous]

I want everybody else to give away their labor but I don’t want to give away mine.

[Anonymous]

Anonymous wrote:I want everybody else to give away their labor but I don’t want to give away mine.

on dcum its awesome when big law, sales and various schmoozing consultants make 1m but when someone saving lives makes 1m they are an a...hole..that's the mindset in the dmv and on dcum and nothing will change it

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't think we can achieve great medical care for all in this country without removing the profit to insurance and pharma companies. It taints everything from doctor recommendations to access to various tests due to coverage, cost, and just even being able to take the best medications possible. That being said, on a personal level, the doctors I have loved all had the same qualities: truly listened (not necessarily for long, but focused), took into consideration personal patient experience and history, made individualized recommendations after careful thought, were not afraid of answering questions, were not condescending and dismissive.

Super. Who will pay for your health care, and who will make the drugs you need?

I am not a policy expert. I do know people in some countries have all those things without the same deep profit entanglement.

Agree. People here need to think outside the US box.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I want everybody else to give away their labor but I don’t want to give away mine.

on dcum its awesome when big law, sales and various schmoozing consultants make 1m but when someone saving lives makes 1m they are an a...hole..that's the mindset in the dmv and on dcum and nothing will change it

I don't think that, but why is 300k+ as a GP in a rural location so bad? I know there is a crisis in terms of finding rural docs and I don't quite get why: you can live so well on that some places, and being a small town doctor has a lot of advantages in terms of life/work balance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To be honest, I don't understand why the healthcare system cannot be reformed such that primary care doctors can spend AT LEAST ONE HOUR with a patient per year.

Lawyers make lots of money and manage to spend an hour here and there with a client, c'mon.

Of course our system is broken and our population is chronically ill and too many dying unnecessarily has something to do with the standard of care being 20 minutes/year with one's primary care physician.

Any idiot can see that there is a strong relationship between those things.

The average primary care doctor has about 2500-3000 patients on their roster, and that's only possible if they are turning people away. People get angry when you decline to take on new patients, because "what am I supposed to do? I need a doctor!" But so do thousands of other people.

Let's say 2500 patients. One hour a year each is a total of 150,000 minutes a year. 2885 minutes a week, which is 577 minutes a workday (with 5 workdays a week). So if your doctor has a smaller than normal number of patients and spends no vacation ever, and takes no lunch break, he or she can open clinic at 8am and will close after working straight through at 6pm every day -- and there's 23 minutes available left over for using the bathroom and drinking water.

None of that includes phone calls, portal messages, or emails. And given that the average percentage of time spent on paperwork for a US physician is at least 40%, that doc will then work from 6pm until midnight on the paperwork, unless they were doing it at the computer while you were talking.

And none of that includes sick visits, or helping the family who was adamant that they are all healthy and won't take up much time because they are never sick -- until they are, and the 39 year old father has brain cancer, and the children are in trauma from it, and the 38 year old mother has clinical depression, and and and. Because those things don't happen often to one family, but spread out over 2500-3000 people, it's common enough.

What you want isn't possible under the current system, PP. It's just math. Can we design another system? Sure. That would be a great discussion. But being mad at the people trying to hold things together right now, just because they cannot make the impossible happen, is what is breaking them. They are leaving. The numbers just get harder, or you just turn more people away.

This. End thread.

So more doctors then?

I mean I would have loved to go to medical school, but I am not rich and not superlative enough for scholarships. Those are the two tracks or lots of debt which means your choices become narrower for paying off the debt.

And being a physician is not a flexible job and with the childcare crisis and expenses without a strong social safety net it means two incomes OR one super income while the other person stays home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I want everybody else to give away their labor but I don’t want to give away mine.

on dcum its awesome when big law, sales and various schmoozing consultants make 1m but when someone saving lives makes 1m they are an a...hole..that's the mindset in the dmv and on dcum and nothing will change it

Yup. Its because those consulting/sales/law jobs don’t affect the posters here - the ones who want more from their doc. Now that they’ve got skin in the game it’s a completely different story.
Typical DCUM entitled a$$holes.

[Anonymous]

They should not charge extra for services that were always expected before (such as returning a phone call).

They should not tack on a new, annual administrative fee when they neither participate with any insurance, nor will they submit any forms on your behalf.

They can work five days a week if they want to earn an upper middle class income.

They should listen to the patient’s concerns and ideas, being open to a two-way conversation about the best plan for moving forward.

None is that is unreasonable , so stop exaggerating.

(If you want/need higher reimbursement levels, work through your professional organization to lobby for system change that resumes all boats. Don’t just kick out your old patients who are living on a fixed income, which is what happens when you go concierge, because you want to work less but make more.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:To be honest, I don't understand why the healthcare system cannot be reformed such that primary care doctors can spend AT LEAST ONE HOUR with a patient per year.

Lawyers make lots of money and manage to spend an hour here and there with a client, c'mon.

Of course our system is broken and our population is chronically ill and too many dying unnecessarily has something to do with the standard of care being 20 minutes/year with one's primary care physician.

Any idiot can see that there is a strong relationship between those things.

The average primary care doctor has about 2500-3000 patients on their roster, and that's only possible if they are turning people away. People get angry when you decline to take on new patients, because "what am I supposed to do? I need a doctor!" But so do thousands of other people.

Let's say 2500 patients. One hour a year each is a total of 150,000 minutes a year. 2885 minutes a week, which is 577 minutes a workday (with 5 workdays a week). So if your doctor has a smaller than normal number of patients and spends no vacation ever, and takes no lunch break, he or she can open clinic at 8am and will close after working straight through at 6pm every day -- and there's 23 minutes available left over for using the bathroom and drinking water.

None of that includes phone calls, portal messages, or emails. And given that the average percentage of time spent on paperwork for a US physician is at least 40%, that doc will then work from 6pm until midnight on the paperwork, unless they were doing it at the computer while you were talking.

And none of that includes sick visits, or helping the family who was adamant that they are all healthy and won't take up much time because they are never sick -- until they are, and the 39 year old father has brain cancer, and the children are in trauma from it, and the 38 year old mother has clinical depression, and and and. Because those things don't happen often to one family, but spread out over 2500-3000 people, it's common enough.

What you want isn't possible under the current system, PP. It's just math. Can we design another system? Sure. That would be a great discussion. But being mad at the people trying to hold things together right now, just because they cannot make the impossible happen, is what is breaking them. They are leaving. The numbers just get harder, or you just turn more people away.

Not all of the patient's turn up every year e.g. my 20 something kids. If they have something urgent outside of the PCP's limited hours or can't get an urgent appointment, they end up at urgent care. I'm on my OB GYN's roster but don't have to go every year anymore.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:On dcurbanmoms it seems that:

People want doctors to make pennies and do work for free….

But they get mad when primary care doctors who make little money are quitting and leaving them without care.

People want doctors who pass and excel on their training exams and have tons of knowledge but then get mad at doctors who “think they know more than them” or the think NP/ PAs are better even though they don’t have to take these exams or do any training.

So seriously what do you want from doctors? Should they even exist anymore?

How about not being rude and condescending to women? Take our pain seriously? Stop telling us it is in our heads ( unless it is) How about when you cancel than you find another appointment sooner than 6 months!

Whose appointment do we cancel to get you in sooner, though?

If I cancel, make me wait sure. But why am I being punished when you cancel? And I've already waitrd six months!

You didn't answer the question.

Neither have you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I want everybody else to give away their labor but I don’t want to give away mine.

on dcum its awesome when big law, sales and various schmoozing consultants make 1m but when someone saving lives makes 1m they are an a...hole..that's the mindset in the dmv and on dcum and nothing will change it

Yup. Its because those consulting/sales/law jobs don’t affect the posters here - the ones who want more from their doc. Now that they’ve got skin in the game it’s a completely different story.
Typical DCUM entitled a$$holes.

dcum wants more from their doc and the doc to be paid less, oh and to have them do pro bono work for no insurance or insurance that doesnt pay them much

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To be honest, I don't understand why the healthcare system cannot be reformed such that primary care doctors can spend AT LEAST ONE HOUR with a patient per year.

Lawyers make lots of money and manage to spend an hour here and there with a client, c'mon.

Of course our system is broken and our population is chronically ill and too many dying unnecessarily has something to do with the standard of care being 20 minutes/year with one's primary care physician.

Any idiot can see that there is a strong relationship between those things.

The average primary care doctor has about 2500-3000 patients on their roster, and that's only possible if they are turning people away. People get angry when you decline to take on new patients, because "what am I supposed to do? I need a doctor!" But so do thousands of other people.

Let's say 2500 patients. One hour a year each is a total of 150,000 minutes a year. 2885 minutes a week, which is 577 minutes a workday (with 5 workdays a week). So if your doctor has a smaller than normal number of patients and spends no vacation ever, and takes no lunch break, he or she can open clinic at 8am and will close after working straight through at 6pm every day -- and there's 23 minutes available left over for using the bathroom and drinking water.

None of that includes phone calls, portal messages, or emails. And given that the average percentage of time spent on paperwork for a US physician is at least 40%, that doc will then work from 6pm until midnight on the paperwork, unless they were doing it at the computer while you were talking.

And none of that includes sick visits, or helping the family who was adamant that they are all healthy and won't take up much time because they are never sick -- until they are, and the 39 year old father has brain cancer, and the children are in trauma from it, and the 38 year old mother has clinical depression, and and and. Because those things don't happen often to one family, but spread out over 2500-3000 people, it's common enough.

What you want isn't possible under the current system, PP. It's just math. Can we design another system? Sure. That would be a great discussion. But being mad at the people trying to hold things together right now, just because they cannot make the impossible happen, is what is breaking them. They are leaving. The numbers just get harder, or you just turn more people away.

This. End thread.

So more doctors then?

I mean I would have loved to go to medical school, but I am not rich and not superlative enough for scholarships. Those are the two tracks or lots of debt which means your choices become narrower for paying off the debt.

And being a physician is not a flexible job and with the childcare crisis and expenses without a strong social safety net it means two incomes OR one super income while the other person stays home.

I think it means more NPs and PAs.

[Anonymous]

Anonymous wrote:On dcurbanmoms it seems that:

People want doctors to make pennies and do work for free….

But they get mad when primary care doctors who make little money are quitting and leaving them without care.

People want doctors who pass and excel on their training exams and have tons of knowledge but then get mad at doctors who “think they know more than them” or the think NP/ PAs are better even though they don’t have to take these exams or do any training.

So seriously what do you want from doctors? Should they even exist anymore?

How does Sweden do it?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To be honest, I don't understand why the healthcare system cannot be reformed such that primary care doctors can spend AT LEAST ONE HOUR with a patient per year.

Lawyers make lots of money and manage to spend an hour here and there with a client, c'mon.

Of course our system is broken and our population is chronically ill and too many dying unnecessarily has something to do with the standard of care being 20 minutes/year with one's primary care physician.

Any idiot can see that there is a strong relationship between those things.

The average primary care doctor has about 2500-3000 patients on their roster, and that's only possible if they are turning people away. People get angry when you decline to take on new patients, because "what am I supposed to do? I need a doctor!" But so do thousands of other people.

Let's say 2500 patients. One hour a year each is a total of 150,000 minutes a year. 2885 minutes a week, which is 577 minutes a workday (with 5 workdays a week). So if your doctor has a smaller than normal number of patients and spends no vacation ever, and takes no lunch break, he or she can open clinic at 8am and will close after working straight through at 6pm every day -- and there's 23 minutes available left over for using the bathroom and drinking water.

None of that includes phone calls, portal messages, or emails. And given that the average percentage of time spent on paperwork for a US physician is at least 40%, that doc will then work from 6pm until midnight on the paperwork, unless they were doing it at the computer while you were talking.

And none of that includes sick visits, or helping the family who was adamant that they are all healthy and won't take up much time because they are never sick -- until they are, and the 39 year old father has brain cancer, and the children are in trauma from it, and the 38 year old mother has clinical depression, and and and. Because those things don't happen often to one family, but spread out over 2500-3000 people, it's common enough.

What you want isn't possible under the current system, PP. It's just math. Can we design another system? Sure. That would be a great discussion. But being mad at the people trying to hold things together right now, just because they cannot make the impossible happen, is what is breaking them. They are leaving. The numbers just get harder, or you just turn more people away.

Not all of the patient's turn up every year e.g. my 20 something kids. If they have something urgent outside of the PCP's limited hours or can't get an urgent appointment, they end up at urgent care. I'm on my OB GYN's roster but don't have to go every year anymore.

And some patients come every 3 months. Look you can argue all day that doctors stink and have this attitude but all it does is cause more burn out and will lead to more doctors leaving. Blaming the doctors won’t really get you anywhere- it’s a systems issue.

I know personally for me, I went to med school seriously a bleeding heart and wanting to take care of patients. I’m in primary care and I do try to listen to patients and take my time but then other patients are waiting and I get backed up. Then I have to return labs which takes time later in the day and I want to be thorough. All of this with my family life is making it so I probably have at most 5 years in this field and I also work part time. So there goes another one and we keep on leaving.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I want everybody else to give away their labor but I don’t want to give away mine.

on dcum its awesome when big law, sales and various schmoozing consultants make 1m but when someone saving lives makes 1m they are an a...hole..that's the mindset in the dmv and on dcum and nothing will change it

Yup. Its because those consulting/sales/law jobs don’t affect the posters here - the ones who want more from their doc. Now that they’ve got skin in the game it’s a completely different story.
Typical DCUM entitled a$$holes.

dcum wants more from their doc and the doc to be paid less, oh and to have them do pro bono work for no insurance or insurance that doesnt pay them much

I would think the ultra rich here see $$$$$ concierge doctors and the best specialists, not an overworked GP with a regular busy practice...